Sample Question 66

ANSWER: b. that finding (for example, X ray) is not used as an adjustment factor in the net adjustment calculation

RATIONALE

The adjustment tables contain multiple factors associated with FH, PE, and CS. The evaluator determines the grade modifier for each of the components, and then chooses the highest value to represent the numerical value for that adjustment. However, if one of the factors in an adjustment grid is used to make a diagnosis, then that same factor is excluded from the determination of that adjustment factor for the net adjustment calculation. For example, if an X ray is used to make a diagnosis, then that X-ray finding will be excluded from the determination of the grade modifier for the adjustment used in the net adjustment calculation (page 582).

Sample Question 76

ANSWER: c. GMFH = 1; GMPE = 0; GMCS...

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